145 articles - From Friday Sep 15 2023 to Friday Sep 22 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Gut |
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Updates to the modern diagnosis of GERD: Lyon consensus 2.0. Criteria that have not performed well in the diagnosis of actionable GERD have been retired. Personalisation of investigation and management to each patient's unique presentation will optimise GERD diagnosis and management. |
| Hepatology |
National prevalence estimates for steatotic liver disease and Sub-Classifications using consensus nomenclature. Our findings highlight the utility of the new consensus nomenclature to address deficiencies present with the old nomenclature, and identify areas that require research to further refine classifications of SLD. |
meta-analyses and systematic reviews
| Clin Gastroenterol Hepatol |
|---|
Withdrawal of Immunomodulators or TNF Antagonists in Patients with Inflammatory Bowel Diseases in Remission on Combination Therapy: A Systematic Review and Meta-analysis. In patients with IBD in sustained corticosteroid-free clinical remission for >6m on combination therapy, de-escalation with TNF antagonist withdrawal, but not IMM withdrawal, was associated with an increased risk of relapse. |
| Endosc Int Open |
Umbrella systematic review of potential quality indicators for the detection of dysplasia and cancer at upper gastrointestinal endoscopy. Image enhancement use, longer examination times, biopsy rate and propofol sedation are potential quality indicators for UGI endoscopy. Neoplasia detection rate and dedicated endoscopy lists are additional potential quality indicators for Barrett's esophagus. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
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Abdominal pain in patients with inflammatory bowel disease in remission: A prospective study on contributing factors. In this cohort of patients with IBD in remission, abdominal pain was common and associated with psychosocial factors. A more holistic treatment approach for patients with IBD suffering from abdominal pain may improve quality of care and subjective wellbeing. |
Association between gut-derived endotoxins and porto-sinusoidal vascular disorder with portal hypertension. PSVD patients display an altered intestinal permeability and endotoxemia correlated to a pro-aggregating/procoagulant state; histologically, PSVD was associated with increased TLR4+ cell involvement and platelet clumps within sinusoids. Our study suggests that LPS-TLR4 pathway could contribute to the pathophysiological basis of PSVD with portal hypertension. |
Clinical trial: Effects of pegozafermin on the liver and on metabolic comorbidities in subjects with biopsy-confirmed nonalcoholic steatohepatitis. Pegozafermin treatment for 20 weeks had beneficial effects on hepatic and metabolic parameters and was well tolerated in subjects with NASH. NCT04048135. |
Integrated safety analysis of filgotinib for ulcerative colitis: Results from SELECTION and SELECTIONLTE. FIL200 and FIL100 were well tolerated with no unexpected safety signals in patients with moderately to severely active UC, regardless of previous biologic exposure or age. Clinicaltrials Gov identifiers (nct numbers) NCT02914522, NCT02914535. |
Liver disease progression in patients with alpha-1 antitrypsin deficiency and protease inhibitor ZZ genotype with or without lung disease. In patients with AATD and lung disease, there is a delay in the diagnosis of comorbid liver disease. Our findings suggest that liver disease may progress more rapidly in patients without comorbid lung disease. |
Microscopic colitis and risk of incident rheumatoid arthritis: A nationwide population-based matched cohort study. Patients with MC are at a nearly two-fold risk of developing RA compared to the general population. Knowledge of this increased risk may expedite evaluation for RA in patients with MC presenting with joint symptoms and/or arthralgia, thus preventing delay until RA diagnosis. |
| Am J Gastroenterol |
Accuracy in polyp size measurement among surgeons, gastroenterologists, trainees and experts: A prospective video-based study. Visual size estimation of polyps is inaccurate independently of training level, sex, and specialty. Size measurement accuracy can be improved using forceps and yields the highest relative accuracy when an adaptive scale technology is used. |
Atherosclerosis as a Risk Factor for IBD: A Population-Based Case-Control Study. A history of an atherosclerotic-related condition is associated with increased odds of developing IBD, particularly among older adults. Future studies should investigate whether drugs targeting atherosclerotic-related inflammation may prevent IBD in higher-risk individuals. |
Baseline Clinical Factors are Associated with Risk of Complications in Crohn's Disease: Appraisal of the AGA Clinical Care Pathway. We found a significant association between the number of AGA risk factors and the risk of disease complication in CD; this association was not significant in UC. The presence of = 3 risk factors in CD leads to the highest risk of complications. The AGA care pathway is a useful tool to stratify patients who are at higher risk of disease complications in CD patients. |
Conventional vs short duration of antibiotics in patients with moderate or severe cholangitis: Non-inferiority randomized trial. Short duration of antibiotics is non-inferior to conventional duration in patients with moderate to severe cholangitis in terms of clinical cure, recurrence of cholangitis and overall mortality. |
Double-blind multicenter randomized clinical trial comparing glucagon vs placebo in the resolution of alimentary esophageal impaction. Glucagon is no more effective than placebo in resolving EFBI or shortening the time required to remove the foreign body. (EUDRA-CT number 2019-004920-40). |
Global prevalence of psychological distress and comorbidity with disorders of gut-brain interactions. This global study shows that psychological distress, somatic symptoms, and DGBI are very common and frequently overlap. The coexistence between psychological distress/somatic symptoms and DGBI seems to be especially detrimental to quality of life and healthcare utilization. Individuals with psychological distress/somatic symptoms and DGBI coexistence appear to be a group vulnerable to psychosocial problems that should be studied further and would likely benefit from psychological/psychiatric interventions. |
Monitoring Patients with Inflammatory Bowel Disease at High Risk of Anal Cancer. This review describes the most recent literature surrounding anal cancer in the IBD population as well as the unique challenges inherent in diagnosing and treating this population. We conclude by proposing a new screening motif based off literature review as well as multidisciplinary clinical experience that aims to increase early detection of anal cancers in the IBD population. |
Older Adult-Onset of Inflammatory Bowel Diseases is Associated With Higher Utilization of Analgesics: A Nationwide Cohort Study. In this nationwide cohort, older adults most commonly received analgesic prescriptions within 1 year after IBD diagnosis. Additional research is needed to examine the etiology and sequelae of increased analgesic prescribing to this demographic. |
Optimizing the management algorithm for adults with functional constipation failing a fiber/laxative trial in general gastroenterology: Cost-effectiveness and cost-minimization analysis. Anorectal function testing appears to be an emergent technology to optimize cost-effective outcomes, overcoming testing costs by phenotyping care. |
Osteoporosis and fragility fractures in patients with cirrhosis evaluated for liver transplantation: Identification of high-risk patients based on computed tomography at evaluation. In cirrhotic patients evaluated for LT, CT scan identified persons with severe osteoporosis without additional costs. |
Randomized trial of prophylactic antibiotics for endoscopic retrograde cholangiopancreatography in patients with biliary obstruction. Antibiotic prophylaxis before ERCP in patients with biliary obstruction resulted in a significantly lower risk of infectious complications, especially cholangitis, than placebo (ClinicalTrials.gov trial number NCT02958059). |
| Clin Gastroenterol Hepatol |
Alpha-1 antitrypsin (AAT) augmentation and the liver phenotype of adults with AAT deficiency (genotype Pi*ZZ). The first evaluation of AAT augmentation on the Pi*ZZ-related liver disease indicates liver safety of a widely used treatment for AATD-associated lung disease. Prospective studies are needed to confirm the beneficial effects and to demonstrate the potential efficacy of exogenous AAT in patients with Pi*ZZ-associated liver disease. |
Long-term Safety Outcomes of Fecal Microbiota Transplantation: Real-World Data over Eight Years from the Hong Kong FMT Registry. This prospective real-world data from Asia's first FMT registry demonstrated that FMT has an excellent long-term safety profile. The risk of developing new medical conditions beyond 12 months after FMT is low. |
PREVALENCE AND PREDICTORS OF BARRETT'S ESOPHAGUS AFTER NEGATIVE INITIAL ENDOSCOPY: ANALYSIS FROM TWO NATIONAL DATABASES. In this study of >350,000 patients, rates of BE on repeat EGD ranged from 1.7-3.4%, and were higher in those with multiple risk factors. Most were likely missed at initial evaluation, underscoring the importance of a high-quality initial endoscopic examination. While routine repeat endoscopic BE screening after a negative initial examination, is not recommended, repeat screening may be considered in carefully selected patients with GERD and = 2 risk factors for BE, potentially using non-endoscopic tools. |
Sex differences in treatment response to nucleos(t)ide therapy in chronic hepatitis B: a multicenter longitudinal study. Sex differences exist for treatment outcomes among hepatitis B patients. Male sex associated with 16% higher likelihood of clinical remission and 31% higher likelihood of biochemical response than females, while viral suppression and HCC incidence were similar between the two groups. |
Use of DPP4 inhibitors and GLP-1 receptor agonists and risk of intestinal obstruction: Scandinavian cohort study. In this analysis of nationwide data from three Nordic countries, previous safety signals indicating an increased risk of intestinal obstruction with use of DPP4 inhibitors and GLP-1 receptor agonists were not confirmed. |
| Endosc Int Open |
Accuracy of polyp characterization by artificial intelligence and endoscopists: a prospective, non-randomized study in a tertiary endoscopy center. Accuracy for polyp characterization by a new commercially available AI system is high, but does not fulfill the criteria for a "resect-and-discard" strategy. |
| Endoscopy |
Patient safety incidents in endoscopy: a human factors analysis of non-procedural significant harm incidents from the National Reporting and Learning System (NRLS). CONCLUSIONS This was the first national-level human factors analysis of endoscopy-specific PSIs. This work will inform safety improvement strategies and should empower individual services to review their approach to safety. |
| Gastroenterology |
CXADR-Like Membrane Protein regulates colonic epithelial cell proliferation and prevents tumor growth. These results reveal novel insights into CLMP function in the colonic epithelium, highlighting an important role in regulating IEC proliferation, suggesting tumor suppressive function in colon cancer. |
Standardizing Randomized Controlled Trials in Celiac Disease: An International Multidisciplinary Appropriateness Study. We developed standardized recommendations for clinical trial design, eligibility criteria, outcome measures, gluten challenge, and disease evaluations for RCTs in patients with CeD. |
Traditional Medicine Pien Tze Huang Suppresses Colorectal Tumorigenesis through Restoring Gut Microbiota and Metabolites. PZH manipulated gut microbiota and metabolites toward a more favorable profile, improves gut barrier function, and suppresses oncogenic and pro-inflammatory pathways, thereby suppressing colorectal carcinogenesis. |
p21 prevents the exhaustion of CD4+ T cells within the antitumor immune response against colorectal cancer. Our data reveal the importance of p21 in controlling cell cycle and preventing exhaustion of Th1 cells. Furthermore, we unveil the therapeutic potential of CDK inhibitors such as Palbociclib to reduce T cell exhaustion for future treatment of patients with colorectal cancer. |
| Gastrointest Endosc |
ERCP using balloon-assisted endoscope versus EUS-guided treatment for common bile duct stones in Roux-en-Y gastrectomy. Effectiveness and safety of BE-ERCP and EUS-AG were comparable in CBD stone removal for patients after R-Y gastrectomy, but complete stone removal after technical success was superior in BE-ERCP. |
| Gut |
DNA-methylation signature accurately differentiates pancreatic cancer from chronic pancreatitis in tissue and plasma. The success of machine-learning to identify an effective marker signature documents the power of this approach. The high diagnostic accuracy of discriminating PDAC from CP could have tremendous consequences for treatment success, once the result from still a limited number of liquid biopsy samples would be confirmed in a larger cohort of patients with suspected pancreatic cancer. |
Disruption of CerS6-mediated sphingolipid metabolism by FTO deficiency aggravates ulcerative colitis. FTO downregulation promoted UC by decreasing CerS6 expression, leading to increased S1P accumulation in IECs and aggravating colitis via m 6 A-dependent mechanisms. Lower FTO expression in UC patients may enhance their response to vedolizumab treatment. |
Enhanced antitumour immunity following neoadjuvant chemoradiotherapy mediates a favourable prognosis in women with resected pancreatic cancer. PDAC tumours of women are more sensitive to gemcitabine-based nCRT, resulting in longer OS after resection compared with men. This may be due to enhanced immunity impeding the infiltration of protumoral M2 macrophages into the TME. Our findings highlight the importance of considering sex disparities and mitigating immunosuppressive macrophage polarisation for personalised PDAC treatment. |
Optimal measurement of gastric emptying of solids in gastroparesis or functional dyspepsia: evidence to establish standard test. Our aim was to assess inter-individual and intra-individual coefficients of variation (COV) in GES in symptomatic patients with Gp or FD with documented slow or normal GES, respectively. Design Scintigraphic GES (T 85% and should be the standard test for suspected gastric emptying disorders. |
| Hepatology |
Bile acid-induced IRF3 phosphorylation mediates cell death, inflammatory responses and fibrosis in cholestasis-induced liver and kidney injury via regulation of ZBP1. We discovered that ZBP1 interacted with RIP1, RIP3 and NLRP3, thereby revealing its potential role in regulation of cell death and inflammation pathways. In conclusion, our data indicate that bile acid-induced IRF3 phosphorylation and the IRF3-ZBP1 axis play a central role in the pathogenesis of cholestatic liver and kidney injury. |
Computational drug prediction in hepatoblastoma by integrating pan-cancer transcriptomics with pharmacological response. We also found that in a cohort of 46 patients with HB, high CDK9 tumour expression was significantly associated with poor prognosis. Our work proves the usefulness of computational methods trained on pan-cancer datasets to reposition drugs in rare paediatric cancers such as HB, and to help clinicians in choosing the best treatment options for their patients. |
Higher need for polycystic liver disease therapy in female patients: sex-specific association between liver volume and need for therapy. Baseline TLV is strongly associated with volume reducing therapy initiation at follow-up in PLD patients, with sex-specific differences in this association. Disease staging systems should use TLV to predict need for future volume reducing therapy in PLD separately for males and females. |
Physiologic changes in the hepatopulmonary syndrome before and after liver transplant: A longitudinal and predictor analysis. We present the largest and longest longitudinal data analysis in HPS. In addition to rates of physiological decline and improvement before and after liver transplantation, we present novel predictors of PaO2 decline and improvement rates. Our findings enhance understanding of the natural history of HPS and provide pathophysiologic clues. Importantly, they may assist providers in prognostication and prioritization before and after transplant. |
RNA nanomedicine in liver diseases. In this review, we discuss in-depth the different types of RNA and nanocarriers used for liver targeting along with their specific applications in metabolic dysfunction-associated steatotic liver disease, liver fibrosis, and liver cancers. We further highlight the strategies for cell specific delivery and future perspectives in this field of research with the emergence of small activating RNA, circular RNA and RNA base editing approaches. |
Spatial proteomics of immune microenvironment in nonalcoholic steatohepatitis-associated hepatocellular carcinoma. Our work provides the first detailed spatial map of single-cell phenotypes and multicellular connections in NASH-HCC. We demonstrate that interactions between MDSCs and TAMs with effector T cells underlie immunosuppression in NASH-HCC and are an actionable target. |
Spatial proximity of Tumor-Immune interactions predicts patient outcome in hepatocellular carcinoma. Highly multiplexed imaging analysis of liver cancer reveals tumor-immune cellular heterogeneity within spatial contexts, such as tumor and CD8+ T cell interactions, which may predict patient survival. |
| J Hepatol |
Cyclosporine vs. tacrolimus after liver transplantation for primary sclerosing cholangitis - a propensity-score matched intention-to-treat analysis. Tacrolimus is associated with better patient and graft survival rates than cyclosporine and should be the standard calcineurin inhibitor in LT for PSC. Impact and implications The most optimal calcineurin inhibitor to use after liver transplantation in patients with primary sclerosing cholangitis has yet to be firmly established. Since randomized trials with long follow-up are unlikely to be performed, multicontinental long-term registry data are essential in informing clinical practices. Our study supports the practice of starting immunosuppression after liver transplantation in patients with primary sclerosing cholangitis with tacrolimus instead of cyclosporine. The retrospective registry-based design is a limitation. |
Machine learning for individualized prediction of hepatocellular carcinoma development after the eradication of hepatitis C virus with antivirals. We developed and externally validated an RSF model with good predictive performance for the risk of HCC after an SVR. The application of this novel model is available on the website. This model could provide the data to consider an effective surveillance method. Further studies are needed to make recommendations for surveillance policies tailored to the medical situation in each country. Impact and implications A novel prediction model for HCC occurrence in patients after hepatitis C virus eradication was developed using machine learning algorithms. This model, using seven commonly measured parameters, has been shown to have a good predictive ability for HCC development and could provide a personalized surveillance system. |
PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B. With a scoring range from 0 to 12 points, a PAGED-B score differentiates the HCC risk. A PAGED-B score significantly differentiates the 5-year HCC risk: low <7 points and high =7 points. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Clin Gastroenterol Hepatol |
|---|
| Gastroenterology |
Pathobionts in IBD: Origins, Underlying Mechanisms, and Implications for Clinical Care. Despite recognizing that pathobionts likely contribute to the pathogenesis of IBD, more work is needed to define their modes of action. Determining whether causal relationships exist between pathobionts and specific disease characteristics could pave the way for improved care for patients, particularly for those not responding to current IBD therapies. |
| Gastrointest Endosc |
| Gut |
Smart capsules for sensing and sampling the gut: status, challenges and prospects. As a compliment to gut sensing smart capsules, significant amount of effort has been put into the development of robotic capsules to collect tissue biopsy and gut microbiota samples to perform in-depth analysis after capsule retrieval which will be a game changer for gut health diagnosis, and this advancement is also covered in this review. The expansion of smart capsules to robotic capsules for gut microbiota collection has opened new avenues for research with a great promise to revolutionise human health diagnosis, monitoring and intervention. |
| J Hepatol |
Endocrine aspects of metabolic dysfunction associated steatotic liver disease (MASLD): Beyond insulin resistance. Thoughtful assessment, based on individual risk factors and findings, and also of management of non-insulin endocrine axes should be performed in the evaluation and management of MASLD. Multiple therapeutic pharmaceutical targets have emerged that leverage various endocrine axes to reduce the fibroinflammatory cascade in metabolic dysfunction associated steatohepatitis (MASH). |
Endoscopic procedures in HEPATOLOGY:CURRENT trends and new developments. As such endohepatology could become an attractive and emerging concept wherein advanced endoscopy might reinforce the medical management of patients with hepatobiliary disorders and their complications after initial basic work-up. In this review, we discuss current trends and future developments within endo-hepatology and the remaining hurdles to overcome. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
|---|
| Gastroenterology |
| Gastrointest Endosc |
| J Hepatol |